Hospice... Grandma.... New Grief.... New Guilt

I got a call today that I was not expecting, although I probably should have been.  I had a palliative care nurse go out to check on my Grandma and fix some issues with her medications.  She called back to say Grandma was doing very poorly, low heart rate, lowish blood oxygenation, low blood pressure, difficulty breathing, she has lost 9 pounds in the last month, etc.  It was time to put her on hospice.  I knew that she was having some bad days where she did not want to eat and would sleep mostly, but after some adjustments to her Alzheimer's medications she seemed more alert.  Heck she called ME Tuesday and we spoke on the phone.  She wanted to make plans for Christmas, and we talked about what gifts she would like to give people.  How can she be dying now?  The nurse explained that towards the end they can have really great highly functional days interspersed with bad days like today.  I came home and called my Mom and then just cried with my husband.  I am not ready to let her go.  I know that she is old.  I know that her mind is not anywhere near what it used to be.  I know that her appetite is poor and she cannot do the things that she loves easily: go shopping, read books, do crafts... I know that her quality of life is declining.  But I am still not ready to lose her.  I know that I am being selfish, but right now I don't care.  I want her to meet her great grandchild who is growing within me now.  I want to have pictures of her with me and Bear and my Mom, four generations.  I have one of me when I am about 3, my Mom, Grandma and my Great Grandmother.  I wanted that so badly for Grace, and I did not get it, I though with Baby Bear I may get that chance again, but now who knows.

I know that end of life medicine is not an exact science, she could live a few more weeks, or months, or rebound and be here for Christmas 2013.  As I so cruelly know nothing is life is guaranteed.  Also the Hospice designation is not what I thought it was a year ago.  I thought about people with terminal cancer on morphine drips dying slowly in a fog to protect them from the pain their bodies emanate.  I my Grandmother's case it means she gets more visits from doctors and nurses.  She does not have to eat or take her medications if she doesn't want to and every effort is made to make her comfortable both physically and mentally.  I know that it is the right decision.  I don't feel guilty about that.  I do feel guilty about all the projects I wanted to do with her: labeling her collection of photographs spanning 60+ years, recording her stories, asking her about her pregnancy with my mother, her good memories, things like that.  I have spent so much time in the last 4 years running her to doctor after doctor that I did not have the time for these important things.  In the last year I have been pregnant and then a grieving mother and my energy for these projects was not there.  Now I may not have the time with her.